JCAHO exempt specimens (was Hammertoes and Bunions)

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Debbie J. Siena, HT(ASCP), Histopathology Manager, Baylor University Medical 
Center, Dallas TX 75246 notes:

>>I thought that you might want to know that there is a new JCAHO directive 
that states something about the medical staff coming up with a list of 
specimens to be exempted from submission to Histology and a list of gross 
only specimens to be prepared, in case your hospital has not come up with 

This requirement from They-Who-Must-Be-Obeyed is not new, though there may 
have been a change in it I don't know about. In my experience these lists are 
done in a very perfunctory fashion, and omit some of the commonest specimens. 
They really need to be done with great care, with input by all involved 
parties, and in-service education of OR people about them.

Guidelines and information in this area are hard to come by, since the issue 
is beneath the notice of academic surgical pathologists. We have no numbers 
as to the usefulness of examining arthroscopic specimens, total knee and hip 
replacement specimens, gastroscopic specimens when a rapid urease test 
(Clo-Test) for Helicobacter is performed, and even (as we have recently 
discussed on PATHO-L) reduction mammoplasty specimens.

The loss of revenue to pathology services here, both professional and 
technical components, is quite great, and a surprising number of surgeons and 
endoscopists begrudge us our small (relative to what they're charging the 
patient) fees.

Bob Richmond
Samurai Pathologist
Knoxville TN

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